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      <AllOtherContributionsAmt>653</AllOtherContributionsAmt>
      <TotalContributionsAmt>1570752</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>Patient Service Revenue</Desc>
        <BusinessCd>624100</BusinessCd>
        <TotalRevenueColumnAmt>63468020</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>63468020</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Employee Retail Pharmacy</Desc>
        <BusinessCd>456110</BusinessCd>
        <TotalRevenueColumnAmt>130021</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>130021</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Congregate Living</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>127068</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>127068</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Quality Revenue</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>40782</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>40782</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalOthProgramServiceRevGrp>
        <TotalRevenueColumnAmt>157053</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>157053</RelatedOrExemptFuncIncomeAmt>
      </TotalOthProgramServiceRevGrp>
      <TotalProgramServiceRevenueAmt>63922944</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>160061</TotalRevenueColumnAmt>
        <ExclusionAmt>160061</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossRentsGrp>
        <RealAmt>241986</RealAmt>
      </GrossRentsGrp>
      <LessRentalExpensesGrp>
        <RealAmt>38959</RealAmt>
      </LessRentalExpensesGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>203027</RealAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>203027</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>20912</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>182115</ExclusionAmt>
      </NetRentalIncomeOrLossGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>1214645</SecuritiesAmt>
        <OtherAmt>6311585</OtherAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>0</SecuritiesAmt>
        <OtherAmt>5653156</OtherAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>1214645</SecuritiesAmt>
        <OtherAmt>658429</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>1873074</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>540977</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>1332097</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>67729858</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>63922944</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>561889</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>1674273</ExclusionAmt>
      </TotalRevenueGrp>
      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>9222</TotalAmt>
        <ProgramServicesAmt>9222</ProgramServicesAmt>
      </GrantsToDomesticOrgsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>30267106</TotalAmt>
        <ProgramServicesAmt>26186595</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4080511</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
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        <ProgramServicesAmt>696495</ProgramServicesAmt>
        <ManagementAndGeneralAmt>108534</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
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        <ProgramServicesAmt>3425072</ProgramServicesAmt>
        <ManagementAndGeneralAmt>533725</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>2235786</TotalAmt>
        <ProgramServicesAmt>1934357</ProgramServicesAmt>
        <ManagementAndGeneralAmt>301429</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>1120495</TotalAmt>
        <ManagementAndGeneralAmt>1120495</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>58980</TotalAmt>
        <ManagementAndGeneralAmt>58980</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>17947923</TotalAmt>
        <ProgramServicesAmt>10628108</ProgramServicesAmt>
        <ManagementAndGeneralAmt>7319815</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>344186</TotalAmt>
        <ManagementAndGeneralAmt>344186</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>2898348</TotalAmt>
        <ProgramServicesAmt>2450158</ProgramServicesAmt>
        <ManagementAndGeneralAmt>448190</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <OccupancyGrp>
        <TotalAmt>1399099</TotalAmt>
        <ProgramServicesAmt>977753</ProgramServicesAmt>
        <ManagementAndGeneralAmt>421346</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>59085</TotalAmt>
        <ProgramServicesAmt>41865</ProgramServicesAmt>
        <ManagementAndGeneralAmt>17220</ManagementAndGeneralAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>41953</TotalAmt>
        <ProgramServicesAmt>41639</ProgramServicesAmt>
        <ManagementAndGeneralAmt>314</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>712185</TotalAmt>
        <ProgramServicesAmt>497707</ProgramServicesAmt>
        <ManagementAndGeneralAmt>214478</ManagementAndGeneralAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>4660283</TotalAmt>
        <ProgramServicesAmt>3256811</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1403472</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>667774</TotalAmt>
        <ProgramServicesAmt>667774</ProgramServicesAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>Medical Supplies</Desc>
        <TotalAmt>7287842</TotalAmt>
        <ProgramServicesAmt>7287842</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Repairs and maintenance</Desc>
        <TotalAmt>2664225</TotalAmt>
        <ProgramServicesAmt>1826403</ProgramServicesAmt>
        <ManagementAndGeneralAmt>837822</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Dues &amp; Memberships</Desc>
        <TotalAmt>159073</TotalAmt>
        <ProgramServicesAmt>46919</ProgramServicesAmt>
        <ManagementAndGeneralAmt>112154</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>77297391</TotalAmt>
        <ProgramServicesAmt>59974720</ProgramServicesAmt>
        <ManagementAndGeneralAmt>17322671</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
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        <EOYAmt>558</EOYAmt>
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      <SavingsAndTempCashInvstGrp>
        <BOYAmt>970543</BOYAmt>
        <EOYAmt>1834046</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
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        <EOYAmt>849468</EOYAmt>
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      <InventoriesForSaleOrUseGrp>
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        <EOYAmt>1821780</EOYAmt>
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      <PrepaidExpensesDefrdChargesGrp>
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        <EOYAmt>1891831</EOYAmt>
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      <LandBldgEquipAccumDeprecAmt>83373770</LandBldgEquipAccumDeprecAmt>
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        <EOYAmt>24935700</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>2523367</BOYAmt>
        <EOYAmt>2384561</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <InvestmentsOtherSecuritiesGrp>
        <BOYAmt>15762000</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <InvestmentsProgramRelatedGrp>
        <BOYAmt>316811</BOYAmt>
        <EOYAmt>316811</EOYAmt>
      </InvestmentsProgramRelatedGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>1901065</BOYAmt>
        <EOYAmt>1347681</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>76016141</BOYAmt>
        <EOYAmt>35382436</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>9214625</BOYAmt>
        <EOYAmt>14548293</EOYAmt>
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      <MortgNotesPyblScrdInvstPropGrp>
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        <EOYAmt>6944924</EOYAmt>
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      <OtherLiabilitiesGrp>
        <BOYAmt>10058984</BOYAmt>
        <EOYAmt>7307561</EOYAmt>
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      <TotalLiabilitiesGrp>
        <BOYAmt>42761084</BOYAmt>
        <EOYAmt>28800778</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>32646416</BOYAmt>
        <EOYAmt>5961081</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>608641</BOYAmt>
        <EOYAmt>620577</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>33255057</BOYAmt>
        <EOYAmt>6581658</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>76016141</BOYAmt>
        <EOYAmt>35382436</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>-9567533</ReconcilationRevenueExpnssAmt>
      <OtherChangesInNetAssetsAmt>-17105866</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>0</FSAuditedInd>
      <FederalGrantAuditRequiredInd>0</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <HospitalInd>X</HospitalInd>
    </IRS990ScheduleA>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <LandGrp>
        <OtherCostOrOtherBasisAmt>836749</OtherCostOrOtherBasisAmt>
        <BookValueAmt>836749</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <InvestmentCostOrOtherBasisAmt>59941</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>70634418</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>49026640</DepreciationAmt>
        <BookValueAmt>21667719</BookValueAmt>
      </BuildingsGrp>
      <EquipmentGrp>
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        <OtherCostOrOtherBasisAmt>34205368</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>31995376</DepreciationAmt>
        <BookValueAmt>2215767</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
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        <DepreciationAmt>2351754</DepreciationAmt>
        <BookValueAmt>215465</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>24935700</TotalBookValueLandBuildingsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>Deferred compensation obligation</Desc>
        <Amt>2384561</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Estimated claims reserve</Desc>
        <Amt>95000</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Estimated third-party payor settlements</Desc>
        <Amt>4828000</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>7307561</TotalLiabilityAmt>
    </IRS990ScheduleD>
    <IRS990ScheduleH documentId="RetDoc1041500001">
      <FinancialAssistancePolicyInd>1</FinancialAssistancePolicyInd>
      <WrittenPolicyInd>1</WrittenPolicyInd>
      <AllHospitalsPolicyInd>X</AllHospitalsPolicyInd>
      <FPGReferenceFreeCareInd>1</FPGReferenceFreeCareInd>
      <Percent150Ind>X</Percent150Ind>
      <FPGReferenceDiscountedCareInd>1</FPGReferenceDiscountedCareInd>
      <Percent250Ind>X</Percent250Ind>
      <FreeCareMedicallyIndigentInd>1</FreeCareMedicallyIndigentInd>
      <FinancialAssistanceBudgetInd>1</FinancialAssistanceBudgetInd>
      <ExpensesExceedBudgetInd>1</ExpensesExceedBudgetInd>
      <UnableToProvideCareInd>0</UnableToProvideCareInd>
      <AnnualCommunityBnftReportInd>0</AnnualCommunityBnftReportInd>
      <FinancialAssistanceAtCostTyp>
        <TotalCommunityBenefitExpnsAmt>544000</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>544000</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00700</TotalExpensePct>
      </FinancialAssistanceAtCostTyp>
      <UnreimbursedMedicaidGrp>
        <TotalCommunityBenefitExpnsAmt>7404100</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>3163669</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>4240431</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.05490</TotalExpensePct>
      </UnreimbursedMedicaidGrp>
      <TotalFinancialAssistanceTyp>
        <TotalCommunityBenefitExpnsAmt>7948100</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>3163669</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>4784431</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.06190</TotalExpensePct>
      </TotalFinancialAssistanceTyp>
      <SubsidizedHealthServicesGrp>
        <TotalCommunityBenefitExpnsAmt>21509529</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>7493611</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>14015918</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.18130</TotalExpensePct>
      </SubsidizedHealthServicesGrp>
      <TotalOtherBenefitsGrp>
        <TotalCommunityBenefitExpnsAmt>21509529</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>7493611</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>14015918</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.18130</TotalExpensePct>
      </TotalOtherBenefitsGrp>
      <TotalCommunityBenefitsGrp>
        <TotalCommunityBenefitExpnsAmt>29457629</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>10657280</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>18800349</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.24320</TotalExpensePct>
      </TotalCommunityBenefitsGrp>
      <BadDebtExpenseReportedInd>1</BadDebtExpenseReportedInd>
      <BadDebtExpenseAmt>2708392</BadDebtExpenseAmt>
      <BadDebtExpenseAttributableAmt>270839</BadDebtExpenseAttributableAmt>
      <ReimbursedByMedicareAmt>9021523</ReimbursedByMedicareAmt>
      <CostOfCareReimbursedByMedcrAmt>14353254</CostOfCareReimbursedByMedcrAmt>
      <MedicareSurplusOrShortfallAmt>-5331731</MedicareSurplusOrShortfallAmt>
      <CostingMethodologyUsedGrp>
        <OtherInd>X</OtherInd>
      </CostingMethodologyUsedGrp>
      <WrittenDebtCollectionPolicyInd>1</WrittenDebtCollectionPolicyInd>
      <FinancialAssistancePrvsnInd>1</FinancialAssistancePrvsnInd>
      <HospitalFacilitiesCnt>1</HospitalFacilitiesCnt>
      <HospitalFacilitiesGrp>
        <FacilityNum>1</FacilityNum>
        <BusinessName>
          <BusinessNameLine1Txt>St Margaret's Health-Spring Valley</BusinessNameLine1Txt>
        </BusinessName>
        <USAddress>
          <AddressLine1Txt>600 East First Street</AddressLine1Txt>
          <CityNm>Spring Valley</CityNm>
          <StateAbbreviationCd>IL</StateAbbreviationCd>
          <ZIPCd>61362</ZIPCd>
        </USAddress>
        <WebsiteAddressTxt>www.aboutsmh.org</WebsiteAddressTxt>
        <StateLicenseNum>0002576</StateLicenseNum>
        <LicensedHospitalInd>X</LicensedHospitalInd>
        <GeneralMedicalAndSurgicalInd>X</GeneralMedicalAndSurgicalInd>
        <EmergencyRoom24HrsInd>X</EmergencyRoom24HrsInd>
        <OtherDesc>12 Provider based clinics</OtherDesc>
      </HospitalFacilitiesGrp>
      <HospitalFcltyPoliciesPrctcGrp>
        <HospitalFacilityName>
          <BusinessNameLine1Txt>St Margaret's Health-Spring Valley</BusinessNameLine1Txt>
        </HospitalFacilityName>
        <FacilityNum>1</FacilityNum>
        <FirstLicensedCYOrPYInd>0</FirstLicensedCYOrPYInd>
        <TaxExemptHospitalCYOrPYInd>0</TaxExemptHospitalCYOrPYInd>
        <CHNAConductedInd>1</CHNAConductedInd>
        <CommunityDefinitionInd>X</CommunityDefinitionInd>
        <CommunityDemographicsInd>X</CommunityDemographicsInd>
        <ExistingResourcesInd>X</ExistingResourcesInd>
        <HowDataObtainedInd>X</HowDataObtainedInd>
        <CommunityHealthNeedsInd>X</CommunityHealthNeedsInd>
        <OtherHealthIssuesInd>X</OtherHealthIssuesInd>
        <CommunityHlthNeedsIdProcessInd>X</CommunityHlthNeedsIdProcessInd>
        <ConsultingProcessInd>X</ConsultingProcessInd>
        <PriorCHNAImpactInd>X</PriorCHNAImpactInd>
        <CHNAConductedYr>21</CHNAConductedYr>
        <TakeIntoAccountOthersInputInd>1</TakeIntoAccountOthersInputInd>
        <CHNAConductedWithOtherFcltsInd>0</CHNAConductedWithOtherFcltsInd>
        <CHNAConductedWithNonFcltsInd>0</CHNAConductedWithNonFcltsInd>
        <CHNAReportWidelyAvailableInd>1</CHNAReportWidelyAvailableInd>
        <RptAvailableOnOwnWebsiteInd>X</RptAvailableOnOwnWebsiteInd>
        <OwnWebsiteURLTxt>See Part V, Page 8</OwnWebsiteURLTxt>
        <PaperCopyPublicInspectionInd>X</PaperCopyPublicInspectionInd>
        <ImplementationStrategyAdoptInd>1</ImplementationStrategyAdoptInd>
        <ImplementationStrategyAdptYr>21</ImplementationStrategyAdptYr>
        <StrategyPostedWebsiteInd>1</StrategyPostedWebsiteInd>
        <StrategyWebsiteURLTxt>www.aboutsmh.org/community-health-needs-assessments/</StrategyWebsiteURLTxt>
        <OrganizationIncurExciseTaxInd>0</OrganizationIncurExciseTaxInd>
        <EligCriteriaExplainedInd>1</EligCriteriaExplainedInd>
        <FPGFamilyIncmLmtFreeDscntInd>X</FPGFamilyIncmLmtFreeDscntInd>
        <FPGFamilyIncmLmtFreeCarePct>150.000000000000</FPGFamilyIncmLmtFreeCarePct>
        <FPGFamilyIncmLmtDscntCarePct>250.000000000000</FPGFamilyIncmLmtDscntCarePct>
        <AssetLevelCriteriaInd>X</AssetLevelCriteriaInd>
        <MedicalIndigencyCriteriaInd>X</MedicalIndigencyCriteriaInd>
        <InsuranceStatusCriteriaInd>X</InsuranceStatusCriteriaInd>
        <UnderinsuranceStatCriteriaInd>X</UnderinsuranceStatCriteriaInd>
        <OtherCriteriaInd>X</OtherCriteriaInd>
        <ExplainedBasisInd>1</ExplainedBasisInd>
        <AppFinancialAsstExplnInd>1</AppFinancialAsstExplnInd>
        <DescribedInfoInd>X</DescribedInfoInd>
        <DescribedSuprtDocInd>X</DescribedSuprtDocInd>
        <ProvidedHospitalContactInd>X</ProvidedHospitalContactInd>
        <ProvidedNonprofitContactInd>X</ProvidedNonprofitContactInd>
        <OtherMethodInd>X</OtherMethodInd>
        <IncludesPublicityMeasuresInd>1</IncludesPublicityMeasuresInd>
        <FAPAvailableOnWebsiteInd>X</FAPAvailableOnWebsiteInd>
        <FAPAvailableOnWebsiteURLTxt>www.aboutsmh.org/financial-assistance/</FAPAvailableOnWebsiteURLTxt>
        <FAPAppAvailableOnWebsiteInd>X</FAPAppAvailableOnWebsiteInd>
        <FAPAppAvailableOnWebsiteURLTxt>www.aboutsmh.org/financial-assistance/</FAPAppAvailableOnWebsiteURLTxt>
        <FAPSummaryOnWebsiteInd>X</FAPSummaryOnWebsiteInd>
        <FAPSummaryOnWebsiteURLTxt>www.aboutsmh.org/financial-assistance/</FAPSummaryOnWebsiteURLTxt>
        <FAPAvlblOnRequestNoChargeInd>X</FAPAvlblOnRequestNoChargeInd>
        <FAPAppAvlblOnRequestNoChrgInd>X</FAPAppAvlblOnRequestNoChrgInd>
        <FAPSumAvlblOnRequestNoChrgInd>X</FAPSumAvlblOnRequestNoChrgInd>
        <NotifiedFAPCopyBillDisplayInd>X</NotifiedFAPCopyBillDisplayInd>
        <CommuntityNotifiedFAPInd>X</CommuntityNotifiedFAPInd>
        <OtherPublicityInd>X</OtherPublicityInd>
        <FAPActionsOnNonpaymentInd>1</FAPActionsOnNonpaymentInd>
        <PermitNoActionsInd>X</PermitNoActionsInd>
        <CollectionActivitiesInd>0</CollectionActivitiesInd>
        <ProvidedWrittenNoticeInd>X</ProvidedWrittenNoticeInd>
        <MadeEffortOrallyNotifyInd>X</MadeEffortOrallyNotifyInd>
        <ProcessedFAPApplicationInd>X</ProcessedFAPApplicationInd>
        <MadePresumptiveEligDetermInd>X</MadePresumptiveEligDetermInd>
        <NondisEmergencyCarePolicyInd>1</NondisEmergencyCarePolicyInd>
        <LookBackMedicareInd>X</LookBackMedicareInd>
        <AmountsGenerallyBilledInd>0</AmountsGenerallyBilledInd>
        <GrossChargesInd>1</GrossChargesInd>
      </HospitalFcltyPoliciesPrctcGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>St. Margaret's Health-Spring Valley</FormAndLineReferenceDesc>
        <ExplanationTxt>Part V, Section B, Line 5: The Community Health Needs Assessment (CHNA) process included representatives from St. Margaret's Health-Spring Valley, members of the Bureau, LaSalle, Marshall, and Putnam County Health Departments, and administrators from key community partner organizations. Members also consisted of individuals with special knowledge of and expertise in the healthcare of the community.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>St. Margaret's Health-Spring Valley</FormAndLineReferenceDesc>
        <ExplanationTxt>Part V, Section B, Line 11: The following needs were identified in the 2021 community health needs assessment. - Healthy Lifestyles, nutrition, physical activity, and obesity - Substance abuse and mental healthThe Hospital and related clinics ceased operation on June 16, 2023 and filed for Chapter 11 bankruptcy in August 31, 2023. Due to staffing and financial issues the Hospital did not address the needs identified in its most recent CHNA.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>St. Margaret's Health-Spring Valley</FormAndLineReferenceDesc>
        <ExplanationTxt>Part V, Section B, Line 13h: When balances considered for financial assistance exceed more than 25% of the income listed on the application, the applicant may be responsible to pay 25% of their income and the remaining balances will be considered financial assistance allowance. If applicant qualifies for the SNAP (food stamp) program through the state of Illinois, balances may be considered for financial assistance allowance. Presumptive financial assistance may be granted to patients with or without insurance.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>St. Margaret's Health-Spring Valley</FormAndLineReferenceDesc>
        <ExplanationTxt>Part V, Section B, Line 15e: St. Margaret's Health-Spring Valley posts a summary of its charity care policy in the admissions/registration areas, waiting rooms, emergency rooms, and other areas the organization finds beneficial to patients. The policy and contact information on financial assistance is provided and discussed during the admission and discharge process. Each patient bill includes an explanation on how to inquire about financial assistance or an uninsured discount.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>St. Margaret's Health-Spring Valley</FormAndLineReferenceDesc>
        <ExplanationTxt>Part V, Section B, Line 16j: Financial Assistance. Upon notification from Registration regarding Self Pay Admissions, Patient Account clerk or staff member from another department tries to contact the patient to discuss availability of financial assistance. Utilization Review distributes applications when financial assistance is requested from nursing or the patient, or upon admission in the nursing unit when possible. Clinic Clerks distribute applications when requested by the patient, or if the patient informs them of problems in paying their bills. Bills, letters regarding balances, and statements sent to the patient explain how to inquire about financial assistance or an uninsured discount. Qualified patients seeking help or options in paying bills for St. Margaret's Health-Spring Valley services, will be offered financial assistance as an option. If a patient chooses to apply for financial assistance, they are given an "Application for Financial Assistance" which is to be completed according to directions on application and returned to the Patient Accounts Center.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>St. Margaret's Health-Spring Valley</FormAndLineReferenceDesc>
        <ExplanationTxt>Part V, Section B, Line 24: All individuals eligible under the Hospital's financial assistance policy are provided a discount for emergency and other medically necessary care. FAP-eligible patients without insurance may be charged gross charges on elective procedures.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 7a:</FormAndLineReferenceDesc>
        <ExplanationTxt>Community Health Needs Assessment website:www.aboutsmh.org/community-health-needs-assessments/</ExplanationTxt>
      </SupplementalInformationGrp>
      <FacilityNum>1</FacilityNum>
      <OthHlthCareFcltsNotHospitalGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>1 - St Margaret's Home Medical Equipment</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>600 East First Street</AddressLine1Txt>
            <CityNm>Spring Valley</CityNm>
            <StateAbbreviationCd>IL</StateAbbreviationCd>
            <ZIPCd>61362</ZIPCd>
          </USAddress>
          <FacilityTxt>Durable medical equipment</FacilityTxt>
        </OthHlthCareFcltsGrp>
      </OthHlthCareFcltsNotHospitalGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 3c:</FormAndLineReferenceDesc>
        <ExplanationTxt>When balances considered for financial assistance exceed more than 25% of the income listed on the application, the applicant may be responsible to pay 25% of their income and the remaining balances will be considered financial assistance allowance. If applicant qualifies for the SNAP (food stamp) program through the state of Illinois, balances may be considered for financial assistance allowance. Presumptive financial assistance may be granted to patients with or without insurance.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 7:</FormAndLineReferenceDesc>
        <ExplanationTxt>Charity care expense was converted to cost based on an overall cost-to-charge ratio addressing all patient segments. Unreimbursed Medicaid on line 7b and the cost for subsidized health services reported on line 7g were calculated using the costing methods used to prepare the cost reports.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>The amount reported on line 2 represents implicit price concessions. The Health Center determines its estimate of implicit price concessions based on its historical collection experience with the class of patients.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Hospital reasonably estimates the portion of implicit price considerations that could have qualified for charity care. An estimated 10% of implicit price concessions in 2023 are attributable to patients potentially eligible for charity care. This is based on the percentage of individuals living below the federal poverty level.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>The footnote to the organization's financial statements addressing implicit price concessions may be found on pages 13 and 14 of the attached audited financial statements.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 8:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Medicare program does not cover all the costs of caring for these patients. Providing these services is essential to these patients and the community and increases their access to healthcare services. Therefore, the entire Medicare shortfall is considered a community benefit. The Organization reported only those allowable costs and Medicare reimbursements reported in the Medicare Cost Report for the year.Total revenue received from Medicare is the gross reimbursement plus settlement. Both total revenue received from Medicare and the Medicare allowable costs are reported from the Medicare Cost Report. The Medicare Cost Report is completed based on the rules and regulations set forth by the Centers for Medicare and Medicaid Services.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 9b:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Hospital does not pursue extraordinary collection activities for 120 days from the date of service while the patient is applying for financial assistance. A 30-day notice is provided to the patient before any collection activities begin. A patient has a total of 240 days to apply for financial assistance.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>St. Margaret's Health-Spring Valley identified unmet community health needs by participating in community coalitions, partnerships, boards, committees, commissions, advisory groups, and panels. For example, Hospital representatives met with the local health department to jointly evaluate the needs of the community. In particular, Hospital staff met with local mental health service providers to discuss unmet mental health needs in the community. On a monthly basis, the Hospital reviews its internal patient surveys. On a tri-annual basis, the Board met with select medical staff members and Hospital staff to develop a strategic plan, which addressed the demographics of the communities served. The Hospital provided health education and outreach at various locations in the community, where participants were educated on the importance of disease prevention and early detection. The Hospital supported a local free clinic by providing free lab services. This allowed employed physicians to donate their services and provide financial assistance.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>St. Margaret's Health-Spring Valley posted a summary of its charity care policy in the admissions/registration areas, waiting rooms, emergency rooms, and other areas the organization found beneficial to patients. The policy and contact information on financial assistance was provided and discussed during the admission and discharge process. Upon notification from Registration regarding self-pay admissions, the Patient Account clerk or staff member from another department tries to contact the patient to discuss availability of financial assistance. Also, information on other programs, such as government benefits, Medicaid or state programs, are discussed with patients. Assistance is also provided for individuals applying for government benefits. Patients are encouraged to explore their options and use our resources to obtain assistance with their bills. Each patient bill includes an explanation on how to inquire about financial assistance or an uninsured discount.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>St. Margaret's Health-Spring Valley was a 44-bed acute care hospital located in Spring Valley, IL. Spring Valley, IL is a city situated on the Illinois river in the southeastern corner of Bureau County, IL. Bureau County is located in the Northcentral region of Illinois. The population is approximately 5,582 people. Spring Valley is part of the "Illinois Valley Micropolitan" (La Salle, Peru, and Spring Valley) which total approximately 25,000 people. Common industries are retail trade, office and administration, material moving, food preparation, and health. The median household income was $50,549 and the unemployment rate was 6.3%. Medicare and public aid make up over 62% of our total patient service revenue. The nearest city with a population greater than 50,000 is Peoria, IL located 47 miles SW of Spring Valley.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 5:</FormAndLineReferenceDesc>
        <ExplanationTxt>To meet the needs of our community, the Hospital extends privileges to medical staff that are qualified and licensed. Surplus funds are invested in facility and equipment upgrades to better serve the health of our population.Our organization was committed to be involved and helpful to the community. The emergency room was open 24 hours a day and everyone was treated regardless of their ability to pay.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 6:</FormAndLineReferenceDesc>
        <ExplanationTxt>We were affiliate of the Sisters of Mary of the Presentation Health System (SMP Health). St. Margaret's Health-Spring Valley operates in accordance with the mission, vision, and values of SMP Health.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleH>
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        <PersonNm>Timothy A Muntz</PersonNm>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Lisa Lynch</PersonNm>
        <TitleTxt>VP of Finance</TitleTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 1a</FormAndLineReferenceDesc>
        <ExplanationTxt>St. Margaret's Health-Spring Valley provides travel for Board Member companions in the years Board Members are required to attend a retreat. The retreat is intended for education on ethics, finance and healthcare.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>St. Margaret's Health-Spring Valley does not pay compensation to Timothy A. Muntz, President &amp; CEO. This individual is compensated by SMP Health, a related organization, for his services at the Hospital. SMP Health uses one or more of the methods on Part I, question 3 to determine his compensation.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 4b</FormAndLineReferenceDesc>
        <ExplanationTxt>SMP Health has a nonqualified deferred compensation plan that complies with Section 409A of the IRC. SMP Health begins contributions into the plan after the employee's first year of service. The employee is vested based on a 20 year vesting schedule or becomes fully vested in the event of death, disability or reaching the age of 65. Employee name and amounts included on Schedule J are as follows: Name Part II, column B (iii) Timothy A. Muntz 37,415</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part III, line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>St. Margaret's Health - Spring Valley ceased operations on Friday, June 16, 2023. On August 31, 2023, the hospital filed a petition for relief under Chapter 11 of the federal bankruptcy law in the United States Bankruptcy Court.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IV, Line 20b:</FormAndLineReferenceDesc>
        <ExplanationTxt>The audit of St. Margaret's Health - Spring Valley for the year ended September 30, 2022 was started in November 2022. The audit was suspended due to outstanding items and never completed. St. Margaret's Health - Spring Valley ceased operations on Friday, June 16, 2023. On August 31, 2023, the hospital filed a petition for relief under Chapter 11 of the federal bankruptcy law in the United States Bankruptcy Court. The audit for fiscal year ending September 30, 2023 was not completed. The Organization has attached a copy of its most recent audited financial statements for the years ended September 30, 2021 and 2020 to the Form 990 and answered yes to Part IV, line 20b.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>The sole member of the organization is St. Margaret's Health.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 7a</FormAndLineReferenceDesc>
        <ExplanationTxt>St. Margaret's Health, sole member, has authority to elect and remove, with or without cause, the Board of Directors of the Corporation or any member of the Board of Directors of the Corporation.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 7b</FormAndLineReferenceDesc>
        <ExplanationTxt>St. Margaret's Health, sole member, has exclusive right to: (a) To establish, approve, or modify the philosophy, vision, values and mission according to which the Corporation operates; (b) To lease, sell, encumber or otherwise alienate any real property or interest in real property of the Corporation; To approve any transfer, lease, sale or encumbrance of personal property of the Corporation except in the ordinary course of business; (d) To approve any purchase or other acquisition by the Corporation that is not included in its operating and capital budgets and exceeds $100,000.00; (e) To approve any borrowing or debt financing on behalf of the Corporation, to structure and restructure indebtedness of the Corporation, and to enter into and amend agreements relating to indebtedness of the Corporation; (f) To require a certified audit of the finances of the Corporation and to appoint the certified public accountant to perform any audit; (g) To approve the engagement of and to dismiss any outside legal counsel to represent the Corporation on a regular basis or in connection with any matter deemed by Member to have significance for the Member and/or its affiliates; (h) To elect and remove, with or without cause, the board of directors of the Corporation or any member of the board of directors of the Corporation; (i) To merge or consolidate the Corporation with other entities, to merge other entities into the Corporation, or to dissolve the Corporation, in accordance with applicable law; (j) To amend the bylaws and Articles of Incorporation of the Corporation in accordance with applicable law; (k) To expand, consolidate, terminate or close any of the facilities and services of the Corporation; (l) To hire, appoint, enter into an employment contract with, discipline, remove or terminate the Corporation President &amp; CEO and to appoint and remove the Corporation Chairperson, Vice Chairperson, Secretary and Chief Financial Officer; (m) To approve strategic plan and management objectives for the Corporation, which will be developed by the Corporation and recommended to Member; (n) To adopt or modify the operating budget and capital budget for any fiscal year for the Corporation, which will be developed by the Corporation and recommended to Member; (o) To give preliminary approval prior to the development of, and to give final approval prior to the execution of, all documents to which the Corporation will be a party to joint ventures and other affiliations with third parties, and approve the creation, formation, organization, or termination of any legal entity in which the Corporation will have any ownership interest, membership interest, power to elect or appoint board members or officers, or any other formal participation arrangement, whether acting alone or in conjunction with any other person or entity; (p) To approve appointments to governing bodies of joint ventures between the Corporation and third parties and other legal entities in which the Corporation has any power to elect or appoint board members or officers; and (q) To take any and all actions deemed necessary, in the sole judgment of the Member, to protect and preserve the tax-exempt status and public charity status of the Member and any tax-exempt affiliate of the Member (including federal and state income tax exemptions, property tax exemptions, and sales tax exemptions); provided the Member has given a written request to the Corporation to take action or refrain from taking action, which would have sufficiently protected and preserved such tax-exempt and public charity status, and the Corporation has failed to promptly take such action or refrain from taking such action.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 8b</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization does not have committees with authority to act on behalf of the governing body.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>The Form 990 is made available to the Board of Directors. The President &amp; CEO and Vice President of Finance review the Form 990.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>Each Director and officer must submit in writing to the Chair of the Board and the President &amp; CEO a list of all business or other organizations of which the individual is an officer, director, trustee, member, owner (either as a sole proprietor or partner), shareholder with a 5% or greater interest in all outstanding voting shares, employee or agent, with which the organization has, or might reasonably in the future enter into, a relationship or a transaction in which the Director would have conflicting interests. Each written statement is resubmitted with any necessary changes each year. The Chair of the Board reviews the statements of the Directors and the Vice Chair of the Board reviews the statement filed by the Chair. When a conflict arises the affected Director makes known the potential conflict, whether disclosed by written statement or not, and after answering any questions, will withdraw from the meeting for as long as the matter continues under discussion. Should the matter be brought to a vote, the affected Director will not vote on it. In the event the Director does not withdraw voluntarily, the Chair of the Board as authority to require the Director to remove himself from the room during both the discussion and vote on the matter. In the event the conflict of interest affects the Chair, the Vice Chair has authority to require the Chairperson remove himself in the same matter. If the matter is the item of business for which a special meeting of the Board was called, the affected Director will not be counted to establish a quorum, and he/she will not participate in the deliberations or vote on it.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 15</FormAndLineReferenceDesc>
        <ExplanationTxt>The Organization's President &amp; CEO and Vice President of Finance are compensated by SMP Health, a related organization. The compensation process is determined by SMP Health. SMP Health's Board of Trustees directly engages a nationally recognized independent compensation consulting firm to review the total compensation arrangements of the officers and key employees. SMP Health's Board of Trustees approves all compensation based on comparable data and documents their decision in the meeting minutes.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>The Organization's governing documents, conflict of interest policy, and financial statements are not available to the public. Financial information is available through the public disclosure copy of the 990.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, line 11g</FormAndLineReferenceDesc>
        <ExplanationTxt>Purchased services: Program service expenses 7,660,839. Management and general expenses 3,877,881. Fundraising expenses 0. Total expenses 11,538,720. Professional fees: Program service expenses 0. Management and general expenses 3,414,064. Fundraising expenses 0. Total expenses 3,414,064. Contract Labor: Program service expenses 2,967,269. Management and general expenses 27,870. Fundraising expenses 0. Total expenses 2,995,139.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, line 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>Equity transfers to affiliates -17,117,703. Change in beneficial interests in assets held by others 11,837.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>SMP Enterprises - IL</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>600 East 1st Street</AddressLine1Txt>
          <CityNm>Spring Valley</CityNm>
          <StateAbbreviationCd>IL</StateAbbreviationCd>
          <ZIPCd>61362</ZIPCd>
        </USAddress>
        <EIN>363456566</EIN>
        <PrimaryActivitiesTxt>Healthcare Management</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>IL</LegalDomicileStateCd>
        <TotalIncomeAmt>2</TotalIncomeAmt>
        <EndOfYearAssetsAmt>1886038</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>St Margaret's Health - Spring Valley</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Illinois Valley Community Hospital Foundation</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>925 W St</AddressLine1Txt>
          <CityNm>Peru</CityNm>
          <StateAbbreviationCd>IL</StateAbbreviationCd>
          <ZIPCd>61354</ZIPCd>
        </USAddress>
        <EIN>371211780</EIN>
        <PrimaryActivitiesTxt>Support IV HealthCorp, Inc.</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>IL</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 12a, I</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>IV HealthCorp Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>IV HealthCorp Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>925 W St</AddressLine1Txt>
          <CityNm>Peru</CityNm>
          <StateAbbreviationCd>IL</StateAbbreviationCd>
          <ZIPCd>61354</ZIPCd>
        </USAddress>
        <EIN>371211890</EIN>
        <PrimaryActivitiesTxt>Support SMP affiliated entities</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>IL</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 12a, I</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>St Margaret's Health</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Presentation Medical Center dba SMP Health - St Kateri</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>213 2nd Ave NE</AddressLine1Txt>
          <CityNm>Rolla</CityNm>
          <StateAbbreviationCd>ND</StateAbbreviationCd>
          <ZIPCd>58367</ZIPCd>
        </USAddress>
        <EIN>450227391</EIN>
        <PrimaryActivitiesTxt>Provision of health care services</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>ND</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SMP Health</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Sisters of Mary of the Presentation Health Ministry</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1202 Page Drive SW</AddressLine1Txt>
          <CityNm>Fargo</CityNm>
          <StateAbbreviationCd>ND</StateAbbreviationCd>
          <ZIPCd>58106</ZIPCd>
        </USAddress>
        <EIN>320617468</EIN>
        <PrimaryActivitiesTxt>Supports SMP Health and the related entities</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>ND</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Sisters of Mary of the Presentation Health System dba SMP Health</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1202 Page Drive SW</AddressLine1Txt>
          <CityNm>Fargo</CityNm>
          <StateAbbreviationCd>ND</StateAbbreviationCd>
          <ZIPCd>58103</ZIPCd>
        </USAddress>
        <EIN>450359620</EIN>
        <PrimaryActivitiesTxt>Support related ND Catholic Health Care System</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>ND</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 12a, I</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SMP Health Ministry</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>SMP Illinois Region Health System dba St Margaret's Health</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>600 E 1st St</AddressLine1Txt>
          <CityNm>Spring Valley</CityNm>
          <StateAbbreviationCd>IL</StateAbbreviationCd>
          <ZIPCd>61362</ZIPCd>
        </USAddress>
        <EIN>842023121</EIN>
        <PrimaryActivitiesTxt>Support related Illinois health care entities</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>IL</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 12a, I</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SMP Health</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>SMP Long Term Care dba SMP Health - Long Term Care</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1202 Page Drive SW</AddressLine1Txt>
          <CityNm>Fargo</CityNm>
          <StateAbbreviationCd>ND</StateAbbreviationCd>
          <ZIPCd>58106</ZIPCd>
        </USAddress>
        <EIN>752999939</EIN>
        <PrimaryActivitiesTxt>Provide extended care and medically related services</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>ND</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SMP Health</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>SMP Prairieland Home Care dba Prairieland Home Care</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1102 Page Drive SW</AddressLine1Txt>
          <CityNm>Fargo</CityNm>
          <StateAbbreviationCd>ND</StateAbbreviationCd>
          <ZIPCd>58106</ZIPCd>
        </USAddress>
        <EIN>450391192</EIN>
        <PrimaryActivitiesTxt>Home health and supportive services</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>ND</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SMP Health</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>St Aloisius Medical Center dba SMP Health - St Aloisius</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>325 E Brewster St</AddressLine1Txt>
          <CityNm>Harvey</CityNm>
          <StateAbbreviationCd>ND</StateAbbreviationCd>
          <ZIPCd>58341</ZIPCd>
        </USAddress>
        <EIN>450226729</EIN>
        <PrimaryActivitiesTxt>Provision of health care services</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>ND</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SMP Health</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>St Andrew's Health Center dba SMP Health - St Andrew's</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>316 Ohmer St</AddressLine1Txt>
          <CityNm>Bottineau</CityNm>
          <StateAbbreviationCd>ND</StateAbbreviationCd>
          <ZIPCd>58318</ZIPCd>
        </USAddress>
        <EIN>450226426</EIN>
        <PrimaryActivitiesTxt>Provision of health care services</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>ND</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SMP Health</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>St Andrew's Hospital Foundation dba SMP Health St Andrew's Foundation Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>316 Ohmer St</AddressLine1Txt>
          <CityNm>Bottineau</CityNm>
          <StateAbbreviationCd>ND</StateAbbreviationCd>
          <ZIPCd>58318</ZIPCd>
        </USAddress>
        <EIN>450413201</EIN>
        <PrimaryActivitiesTxt>Support SMP Health - St. Andrew's</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>ND</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 12a, I</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SMP Health</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>St Margaret's Health-Peru</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>925 W St</AddressLine1Txt>
          <CityNm>Peru</CityNm>
          <StateAbbreviationCd>IL</StateAbbreviationCd>
          <ZIPCd>61354</ZIPCd>
        </USAddress>
        <EIN>362852553</EIN>
        <PrimaryActivitiesTxt>Provision of health care services</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>IL</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>IV HealthCorp Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>St Margaret's Hospital Foundation</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>600 E 1st St</AddressLine1Txt>
          <CityNm>Spring Valley</CityNm>
          <StateAbbreviationCd>IL</StateAbbreviationCd>
          <ZIPCd>61362</ZIPCd>
        </USAddress>
        <EIN>364042262</EIN>
        <PrimaryActivitiesTxt>Support SMP Health - St. Margaret's</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>IL</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 12a, I</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SMP Health</BusinessNameLine1Txt>
        </DirectControllingEntityName>
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        <RelatedOrganizationName>
          <BusinessNameLine1Txt>SMP Enterprises</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>PO Box 10007</AddressLine1Txt>
          <CityNm>Fargo</CityNm>
          <StateAbbreviationCd>ND</StateAbbreviationCd>
          <ZIPCd>581060007</ZIPCd>
        </USAddress>
        <EIN>363486506</EIN>
        <PrimaryActivitiesTxt>Collection Agency</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>ND</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
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      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Illinois Valley Health Services Inc</BusinessNameLine1Txt>
        </RelatedOrganizationName>
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          <AddressLine1Txt>925 W St</AddressLine1Txt>
          <CityNm>Peru</CityNm>
          <StateAbbreviationCd>IL</StateAbbreviationCd>
          <ZIPCd>61354</ZIPCd>
        </USAddress>
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        <PrimaryActivitiesTxt>Inactive</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>IL</LegalDomicileStateCd>
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        <EntityTypeTxt>C</EntityTypeTxt>
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      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Health Care Building Corp</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>925 W St</AddressLine1Txt>
          <CityNm>Peru</CityNm>
          <StateAbbreviationCd>IL</StateAbbreviationCd>
          <ZIPCd>61354</ZIPCd>
        </USAddress>
        <EIN>363306917</EIN>
        <PrimaryActivitiesTxt>Inactive</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>IL</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Valley Health Enterprises Inc</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>925 W St</AddressLine1Txt>
          <CityNm>Peru</CityNm>
          <StateAbbreviationCd>IL</StateAbbreviationCd>
          <ZIPCd>61354</ZIPCd>
        </USAddress>
        <EIN>363476877</EIN>
        <PrimaryActivitiesTxt>Home medical equipment</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>IL</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>IVCH General Professional Liability Loss Fund</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>925 W St</AddressLine1Txt>
          <CityNm>Peru</CityNm>
          <StateAbbreviationCd>IL</StateAbbreviationCd>
          <ZIPCd>61354</ZIPCd>
        </USAddress>
        <EIN>366673231</EIN>
        <PrimaryActivitiesTxt>Inactive</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>IL</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>T</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>0</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>1</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>0</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>1</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>1</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>1</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>1</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>1</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>1</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
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</Return>